November 22, 2010

'Theorizing Mental Health Courts"

The title of this post is the title of this new article by E. Lea Johnston that is now available via SSRN. Here is the abstract:

To date, no scholarly article has analyzed the theoretical basis of mental health courts, which currently exist in forty-three states. This article examines the two utilitarian justifications proposed by mental health court advocates -- therapeutic jurisprudence and therapeutic rehabilitation -- and finds both insufficient. Therapeutic jurisprudence is inadequate to justify mental health courts because of its inability, by definition, to resolve significant normative conflict. In essence, mental health courts express values fundamentally at odds with those underlying the traditional criminal justice system. Furthermore, the ability of therapeutic rehabilitation to offer sufficient theoretical grounding depends on the validity of the assumed link between mental illness and crime. In particular, mental health courts view participants’ criminal behavior as symptomatic of their mental illnesses and insist that untreated mental illness serves as a major driver of recidivism. Drawing upon social science research, this article demonstrates that these relationships may not hold for a substantial proportion of individuals served by mental health courts. The article concludes by identifying alternative theories that may justify these courts.

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In 1976, the vile lawyer hierarchy took over psychiatry to generate jobs for 3 lawyers each time someone needed treatment. It invented a couple of legal pretexts without any basis in fact. There was no abuse of the two physician process prior to that. If there were any abuse, there were plenty of remedies in the criminal law, and in torts.

Since that horrible, dark day, the lawyer has interfered and prevented the treatment of 1,000,000 suicides, and 60,000 murders by paranoid schizophrenics. If you like V Tech, thank the vile intermeddlers on the Supreme Court. Every single one of those death could have been prevented had the lawyer not taken over the field of psychiatry.

Here is a funny anecdote. In my nearby city, the lawyers and judges are nuts. Every involuntary commitment hearing requires an all out defense of the constitution, as if they were the dream team junior. The doctor arrives to a hearing 5 minutes late, and profusely apologizes. The clerk takes him aside, and says, no problem doctor. Here is your commitment paper. You may take the patient back with you, now. What the...? No dramatics, no withering cross examination and parsing of exculpatory evidence, no motions to defend the constitution? Nope. This patient happened to be in a manic state, and the janitor of the court, disrupting the place.

Here is a better story, from the lawyer Twilight Zone. A superzealous defense attorney fought every commitment case to the death. She would destroy the will of the doctors by getting continuances, and taking up time they did not have. She would demand records from long ago. Etc. She goes to Israel to teach Israeli defense attorneys what she does at a seminar on horrible defense lawyer methodology. She finishes her presentation. She gets on a public bus to return to the hotel. In jumps a screaming Arab. He plunges a knife into her chest, a totally random victim. Later, he is determined to not belong to any terror organization, but to be a released paranoid schizophrenic. The local news team flies to Israel, to the side of her intensive care unit bed. They tell her about her assailant. She forgives him, saying he did not really mean to stab her. Then,...

She dies.

I am sitting at a dinner table with a very close friend of hers. I ask her about her mental state, because she seemed obsessed. No, the friend says, she really believed she was defending the constitution in every single one of her commitment hearing cases.

Awakens terrible memories of grad school, where they made me read thousands of pages of stuff like this...and then answer questions about it as if it made sense.

Apparently lunatics typically commit crimes for the same reasons ordinary criminals do (pathology notwithstanding)...which further complicates the question of how to deal with them. So we need to think about it some more. That about cover it?